Recent research from Michigan Medicine has challenged the long-held belief that adenotonsillectomy, the surgical removal of the tonsils and adenoids, is linked to substantial weight gain in children experiencing mild sleep-disordered breathing.
The findings, published in the journal JAMA Otolaryngology–Head & Neck Surgery, encourage healthcare providers to focus on effective weight management methods for their young patients.
Study Overview
Historically, the notion that adenotonsillectomy leads to excessive weight gain in children has been prevalent.
However, this new study indicates that this claim lacks substantial evidence.
The research analyzed data from the Pediatric Adenotonsillectomy Trial for Snoring, which included 458 children diagnosed with mild sleep-disordered breathing.
Participants were divided into two groups: one group underwent adenotonsillectomy, while the other received supportive care through a strategy known as “watchful waiting.” The study evaluated various outcomes, revealing that although the surgery did not lead to significant improvements in primary neurodevelopmental results, it did show benefits in some secondary areas, such as symptoms, quality of life, and blood pressure.
This analysis specifically assessed the potential link between the surgery and unwanted weight gain.
Key Findings
The principal investigator of the study emphasized that earlier associations between tonsillectomy and weight gain stemmed from studies that did not control for various factors adequately.
The findings suggest that the weight gain typically observed in children who are overweight is a natural progression that is not directly related to whether they have undergone surgery for sleep apnea.
The relationship between a child’s weight and sleep-disordered breathing is intricate.
Children with obesity are more likely to experience these symptoms, while underweight children dealing with sleep-related issues might see improved weight gain following adenotonsillectomy.
Researchers argue that the “catch-up” growth seen in underweight children could have led to misconceptions about the surgery causing unwanted weight gain when these children were analyzed alongside their normal and overweight peers.
Clinical Implications
Earlier research from the same team, which focused on data from another randomized trial concerning children with obstructive sleep apnea, also found that adenotonsillectomy is unlikely to independently contribute to weight gain in children.
In the context of the current study, researchers defined undesirable weight gain using two categories: underweight or normal-weight children who transitioned to being overweight after a year, and overweight children who continued to gain weight in the same timeframe.
Among those who had the surgery, 32% experienced unwanted weight gain, compared to 27% in the watchful waiting group.
However, the statistical analysis did not identify a statistically significant link between adenotonsillectomy and weight gain.
The study provides reassurance for sleep specialists and otolaryngologists who may have concerns about whether recommending tonsil removal might elevate a child’s obesity risk, particularly in light of widespread concerns about obesity.
While the study concludes that adenotonsillectomy is not a direct factor in weight gain, it is noted that nearly one-third of participants did experience unwanted weight gain after surgery.
The researchers underscore the necessity for healthcare professionals to advocate for effective weight management strategies for children facing mild sleep-disordered breathing.
Funding for this research was supported by the National Heart, Lung, and Blood Institute.
“`htmlStudy Details:
- Title: Weight Gain After Adenotonsillectomy in Children With Mild Obstructive Sleep-Disordered Breathing: Exploratory Analysis of the PATS Randomized Clinical Trial
- Authors: Erin M. Kirkham, Stacey Ishman, Cristina M. Baldassari, Ron B. Mitchell, S. Kamal Naqvi, Ignacio E. Tapia, Lisa M. Elden, Fauziya Hassan, Sally Ibrahim, Kristie Ross, Mengqi Cen, Rui Wang, Susan Redline, Ronald D. Chervin
- Journal: JAMA Otolaryngology–Head & Neck Surgery
- Publication Date: August 22, 2024
- DOI: 10.1001/jamaoto.2024.2554